Contingency management (CM) is a paradigm developed in the USA and found to be one of the most effective treatment options for managing methamphetamine dependence. The conventional paradigm involves providing increasingly valuable reinforcers (vouchers/prize draws) for consecutive drug-free urines. The aim of this project is to explore options for implementing CM for methamphetamine dependence in different services in Australia. Results will be used to identify models of CM that have the potential to be taken to scale and to deliver an effective treatment to address methamphetamine use within routine clinical care in Australia.
Dr Shalini Arunogiri (Monash University)
Dr Alison Marshall (Kirby Institute, UNSW)
A/Prof Meredith Ginley (Eastern Tennessee State University)
Prof Jason Grebely (Kirby Institute, UNSW)
Dr Dean Membrey (Cohealth, Western Health)
Dr Paul McCartney (Cohealth, Western Health)
Dr Michael Christmas (Next Step Drug and Alcohol Services, Perth)
Jack Nagle (Connections Based Living)
There are no approved pharmacotherapies for methamphetamine dependence, with treatment reliant on psychosocial strategies. Contingency Management (CM) is the only psychosocial intervention which has strong evidence for reducing methamphetamine use. CM has never been trialled for methamphetamine use in Australia even though its effect size for the treatment of stimulant dependence is greater than any existing treatment used here. This paradigm has garnered limited support from Australian clinicians, indicating a need for cultural adaptation to the Australian treatment system.
- To provide an understanding of the different models of CM and options for their implementation to address methamphetamine dependence
- To identify models of CM that can potentially be implemented in different service settings (e.g., private GPs, primary health care, specialist drug treatment, post-release peer-outreach) to respond to methamphetamine use
- To understand barriers and facilitators to the implementation/up-take of CM amongst policy-makers, clinicians and people with lived experience
The research will involve five phases:
- Expert Working Group - We will establish an international expert working group to help identify different possible models of CM and how they can be adapted to different service settings.
- Scoping review – A scoping review will be conducted to identify different models of CM and implementation options.
- Focus groups – Focus groups will be conducted with representatives from indicative implementation settings and interest groups (private GPs, primary health care, specialist drug treatment, peer-outreach, policy makers), to identify likely feasible and acceptable models of CM for use in the Australian treatment system.
- Online survey – A survey of people who use methamphetamine will be conducted to assess the acceptability of, and preferences for, different CM models and the components thereof.
- In-depth interviews – Interviews will be conducted with people who use methamphetamine to obtain more detailed information on the acceptability and feasibility of different CM models.
This research will identify models of CM that have the potential to be taken up by services in Australia to respond to methamphetamine use. The research will exploit opportunities to adapt CM to optimize the benefits of existing services (e.g., by improving treatment attendance) in addition to directly addressing methamphetamine use (i.e., to increase abstinence rates).